Adenoma Detection Rate in 45- to 49-year-olds in the GIQuIC Registry
Douglas K. Rex, MD, MASGE, reviewing Bilal M, et al. Am J Gastroenterol 2022 Feb 15.
According to 2014-2020 data from the GI Quality Improvement Consortium (GIQuIC) Registry, 2.81 million screening colonoscopies were performed by 814 endoscopists in patients aged 45 to 75 years. This included 47,213 colonoscopies in patients aged 45 to 49 years, 1.01 million colonoscopies in patients aged 50 to 54 years, and 2.76 million colonoscopies in patients aged 50 to 75 years. The adenoma detection rate (ADR) was 28.6% in the 45- to 49-year-old group, 31.8% in the 50- to 54-year-old group, and 36.3% in all 50- to 75-year olds. The ADR in 45- to 49-year-olds was the same after inclusion of patients with a positive family history.
COMMENTIt’s not clear from the registry why persons aged 45 to 49 years without a family history of colorectal cancer were undergoing screening colonoscopy in this interval. Nevertheless, the lack of difference between persons in that age group with and without a family history suggests that the overall result is valid. This is not the first study to show a lack of effect of family history on adenoma prevalence. Given the ease with which effective colonoscopists can reach the current minimum recommended thresholds for ADR (≥25%), these data suggest that, although substantial numbers of screening colonoscopies in patients aged 45 to 49 years will lower ADR a bit, there is currently no reason to lower the minimum acceptable ADR threshold to adjust for the new screening age of 45 years.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Bilal M, Holub J, Greenwald D, Pochapin MB, Rex DK, Shaukat A. Adenoma detection rates in 45-49 year old persons undergoing screening colonoscopy: analysis from the GIQuIC Registry. Am J Gastroenterol 2022 Feb 15. (Epub ahead of print) (https://doi.org/10.14309/ajg.0000000000001684)
